open access

Vol 70, No 10 (2012)
ECG
Published online: 2012-10-19
Submitted: 2012-12-28
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Abnormal electrocardiogram with signs of an old infero-lateral myocardial infarction scar. Hypertrophic cardiomyopathy has not one name

Piotr Kukla, Marek Jastrzębski, Wojciech Kurdzielewicz
Kardiol Pol 2012;70(10):1068-1070.

open access

Vol 70, No 10 (2012)
ECG
Published online: 2012-10-19
Submitted: 2012-12-28

Abstract

We described a case of a 59-year-old woman without clinical significance. Abnormal resting electrocardiogram (ECG) was the cause of the cardiology consultation. The patient complained of the poor exercise tolerance for a year. The resting ECG showed: sinus rhythm 58/min, left axis deviation (QRS axis: 79o), PQ interval: 108 ms, P wave axis: 77o, QRS duration: 106 ms, QT/QTc interval: 452/450 ms. QS morphology in leads: II, III, aVF and V5–V6 with QRS (QS) fragmentation. The Q wave in lead V4 with its duration of 20 ms, and amplitude of 2 mm. The poor progression of R wave in leads V2 and V3. Positive, symmetric T waves in leads: II, III, aVF and V5–V5. Negative T wave in leads I and aVL. Increased S wave amplitude in leads: V2 — 33 mm, V3 — 29 mm. Positive QRS direction in lead aVR. What should be taken into consideration in differential diagnosis? 1) previous infero-lateral myocardial infarction; 2) myocardial hypertrophy; 3) possibility of preexcitation. Based on echocardiography hypertrophic cardiomyopathy was recognised with marked septum hypertrophy to 28 mm and with normal thickness of posterior wall (9 mm). The magnetic resonance of the heart confirmed the echocardiography findings.

Abstract

We described a case of a 59-year-old woman without clinical significance. Abnormal resting electrocardiogram (ECG) was the cause of the cardiology consultation. The patient complained of the poor exercise tolerance for a year. The resting ECG showed: sinus rhythm 58/min, left axis deviation (QRS axis: 79o), PQ interval: 108 ms, P wave axis: 77o, QRS duration: 106 ms, QT/QTc interval: 452/450 ms. QS morphology in leads: II, III, aVF and V5–V6 with QRS (QS) fragmentation. The Q wave in lead V4 with its duration of 20 ms, and amplitude of 2 mm. The poor progression of R wave in leads V2 and V3. Positive, symmetric T waves in leads: II, III, aVF and V5–V5. Negative T wave in leads I and aVL. Increased S wave amplitude in leads: V2 — 33 mm, V3 — 29 mm. Positive QRS direction in lead aVR. What should be taken into consideration in differential diagnosis? 1) previous infero-lateral myocardial infarction; 2) myocardial hypertrophy; 3) possibility of preexcitation. Based on echocardiography hypertrophic cardiomyopathy was recognised with marked septum hypertrophy to 28 mm and with normal thickness of posterior wall (9 mm). The magnetic resonance of the heart confirmed the echocardiography findings.
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Keywords

electrocardiogram; hypertrophic cardiomyopathy; pathologic Q wave

About this article
Title

Abnormal electrocardiogram with signs of an old infero-lateral myocardial infarction scar. Hypertrophic cardiomyopathy has not one name

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 70, No 10 (2012)

Pages

1068-1070

Published online

2012-10-19

Bibliographic record

Kardiol Pol 2012;70(10):1068-1070.

Keywords

electrocardiogram
hypertrophic cardiomyopathy
pathologic Q wave

Authors

Piotr Kukla
Marek Jastrzębski
Wojciech Kurdzielewicz

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